Abstract

Wall shear stress (WSS), the frictional force exerted on endothelial cells by blood flow, is hypothesised to influence atherosclerotic plaque growth and composition. We developed a methodology for image registration of MR and histology images of advanced human carotid plaques and corresponding WSS data, obtained by MRI and computational fluid dynamics.The image registration method requires four types of input images, in vivo MRI, ex vivo MRI, photographs of transversally sectioned plaque tissue and histology images. These images are transformed to a shared 3D image domain by applying a combination of rigid and non-rigid registration algorithms. Transformation matrices obtained from registration of these images are used to transform subject-specific WSS data to the shared 3D image domain as well. WSS values originating from the 3D WSS map are visualised in 2D on the corresponding lumen locations in the histological sections and divided into eight radial segments. In each radial segment, the correlation between WSS values and plaque composition based on histological parameters can be assessed. The registration method was successfully applied to two carotid endarterectomy specimens. The resulting matched contours from the imaging modalities had Hausdorff distances between 0.57 and 0.70 mm, which is in the order of magnitude of the in vivo MRI resolution. We simulated the effect of a mismatch in the rigid registration of imaging modalities on WSS results by relocating the WSS data with respect to the stack of histology images. A 0.6 mm relocation altered the mean WSS values projected on radial bins on average by 0.59 Pa, compared to the output of original registration. This mismatch of one image slice did not change the correlation between WSS and plaque thickness. In conclusion, we created a method to investigate correlations between WSS and plaque composition.

Highlights

  • Atherosclerosis is a progressive vascular disease, characterised by the accumulation of lipids and inflammatory cells in the vessel wall, which results in plaque formation

  • We developed the first MRI-based pipeline to register Wall shear stress (WSS) data to histology images

  • We demonstrated that a mismatch of one slice does not significantly affect WSS distribution or the relation between WSS and plaque thickness

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Summary

Introduction

Atherosclerosis is a progressive vascular disease, characterised by the accumulation of lipids and inflammatory cells in the vessel wall, which results in plaque formation. Wall shear stress and histology atherosclerotic plaques is prone to rupture [1,2,3]. A rupture-prone, vulnerable plaque differs compositionally from a stable plaque, and is characterised by a large lipid core covered by a thin fibrous cap, inflammatory cell infiltration and/or intraplaque haemorrhage. In the event of rupture, plaque- and thrombus material may embolise into the distally located vessel bed. Depending on the anatomical location of the plaque, rupture might lead to stroke or acute myocardial infarction. Unravelling the mechanisms behind plaque destabilisation, leading to a rupture-prone plaque, is of high importance

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